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3 Objectives Define the major types of abuse Identify signs, symptoms and possible circumstances for each type of abuse/neglect Outline staff responsibility in identifying and reporting alleged or suspected abuse

7 Over protectiveness of caregiver/refusal to leave pt s side Discrepancy in patient s and family s story Bruises in various stages of healing History of previous trauma in patient or sibling

8 Child Abuse: Definitions Physical abuse: evidence of skin bruising, bleeding, malnutrition, failure to thrive, burns, fractures to any bone, subdural hematoma, soft tissue swelling or death and the condition is not justifiably explained or the history given is at variance with the degree or type of injury/condition. (See WMC Clinical Practice policy D-90 for more info)

21 Neglect: Occurs when adequate food, clothing, shelter, psychological care, physical care, medical care, or supervision is not secured for the at risk adult or is not provided by a caretaker in a timely manner and with the degree of care that a reasonable person in the same situation would exercise.

22 Exploitation: The illegal or improper use of an at risk adults finances or resources for another person s profit or advantage.

23 Self neglect: The act or failure whereby an at risk adult substantially endangers the his own health, safety, welfare or life by not seeking or obtaining services necessary to meet his needs.

29 Domestic Abuse: Definition The infliction or threat of infliction of any bodily injury or harmful physical contact, or the destruction of property or the threat thereof as a method of coercion, control, revenge or punishment upon a person involved in an intimate relationship with the abuser.

30 Domestic Abuse: Signs and Symptoms Injuries to face, head, chest, breasts, and abdomen Injuries during pregnancy Bruises and lacerations where normally covered by clothing and in various stages of healing Suicide attempts

31 Family member insists on staying close to patient Excessive control of financial resources Questioning every expense and keeping financial secrets

32 Nursing Interventions Routinely assess for abuse/neglect (on admission and as indicated) Interview patient in a private environment Assess and maintain patient s immediate safety Listen and support with a nonjudgmental attitude Document in medical record Report suspected abuse or neglect to Care Coordination immediately

33 Hospital policy requires that suspected abuse or neglect be reported immediately. Initial interventions must include the collection of and safeguarding of any evidentiary material (use WMC Security as resource).

34 Reporting Responsibilities Report any suspected or alleged abuse/neglect to Care Coordination (seven days a week, 8 a.m. 5 p.m.). The Care Coordinator may assist you in reporting to the appropriate agency. At all other times, the House Supervisor is notified and they will contact Wesley Security as necessary. Security will contact law enforcement as appropriate.

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